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A common symptom of getting braces is swollen or irritated gums in the weeks that immediately follow installation, or in the days that follow a dentist or orthodontist appointment for adjustments. However, if swelling or bleeding begins to come on arbitrarily, it could be a sign of periodontal disease that may require attention from a professional or adjustments to your oral hygiene regimen. The remedy could be something as simple as just needing to switch to a more sensitive flossing method, such as a water flosser. Here, we’ll outline some possible causes for bleeding gums and what you should do if this happens.

Potential Cause #1: You recently had a check-up and your dentist/orthodontist adjusted your braces

Ultimately, your teeth are bones, and moving them into place along the jawline via long-term continuous applied pressure (which is how braces move your teeth into place) can cause your gums to be swollen or irritated. Gum tenderness, sensitivity, and bleeding after a recent adjustment to the hardware is common and should subside within one week.

What to do:

If the bleeding doesn’t subside within a week of your appointment, schedule a follow-up with your dentist and let them know. They may adjust your treatment plan accordingly.

Potential Cause #2: Early-stage gingivitis

  While it is always important to brush regularly and to floss once a day, those with braces need to be extra diligent. How to floss and how often to floss with braces are common questions because braces add additional obstacles to accessing already hard-to-reach areas in the mouth. They also increase the amount of surface area that bacteria can settle into and multiply, safely away from the areas the bristles of a regular toothbrush can reach. With or without braces, bacteria left on the teeth or gums and left untreated for too long can irritate gums. This can cause gums to become tender, bleed easily, and to recede. Thus, the need for proper braces care is evident.

What to do:

If your gums started to bleed arbitrarily, it is often a sign that your current oral hygiene routine is falling short. You could be in the early stages of developing gum disease. Luckily, if caught early enough, gum disease can be reversed by making some adjustments to your personal care routine, such as:

  • Switch your toothbrush to an electric version. Spend more time to your brushing routine — focus on brushing each tooth individually. Be sure to thoroughly cover both the front and backside surfaces.
  • Ensure that every bracket, as well as the wire of your braces, are fully cleaned from debris as they can be transferred onto the surfaces of your teeth.
  • Rinse your mouth after eating to flush out any loose food particles that remain from your meal.
  • Improper flossing can also allow for bacteria to fester long enough to irritate gums and cause them to bleed. Braces make flossing more challenging. Dental floss isn’t the easiest or most effective method for flossing with braces. The best way to floss your teeth with braces is to use flossing products that are specifically designed to address these obstacles, such as dental threaders, interproximal brushes, or water flossers
  • Ask your dentist for advice or a demonstration of how to floss in a way that is mindful to your braces while cleaning the areas between your teeth effectively. 
  • When your gums do bleed, gargle salt water to rinse the blood out as well as clean the affected area. 
  • Incorporate mouthwash into your daily routine to flush out any dental plaque that you may have dislodged while brushing and flossing.
  • Ask your dentist about fluoride rinses, which have been clinically shown to better protect teeth from cavities and decay by adding a thin, protective layer over teeth and gums.

In most cases, dialing up your brushing and flossing efforts should resolve the issues of bleeding gums when you have braces within a week or so. If they don’t, schedule an appointment with your dentist or orthodontist to check whether something more serious is going on that requires professional work, such as plaque hardened against the surfaces of your teeth (tartar or calculus) that can’t be removed with at-home cleaning methods.

Other rarer, but potential causes for bleeding gums for people with braces

  • Pregnant women with braces may experience bleeding due to hormonal fluctuations that cause extra cell production in the gums. If you are pregnant and experiencing bleeding gums with braces, talk to your dentist about the best course of action. They may recommend incorporating vitamin supplements that can help curtail the bleeding.
  • If your braces are not fitted properly or there is a piece of the hardware that is out of place, a broken piece of hardware could be causing the affected area to become irritated and swollen, causing them to bleed. This type of issue should be more localized and can be quickly repaired by your dentist. 

Make sure you are taking good care of your teeth and gums, particularly if you wear braces. You’ve made the commitment to your dental health by getting them in the first place, so it would be a shame to compromise those efforts by not properly taking care of them. With regular dental checkups, regular brushing, and proper flossing, you can ensure good oral hygiene and help prevent bleeding gums. There is a light at the end of this process – a beautiful, smile you’ll be proud to show off, as well as healthy teeth and gums that will last for years to come. 

Sources:

  1. Tricia Mool: What swollen gums with braces means for your oral health. Colgate. https://www.colgate.com/en-us/oral-health/cosmetic-dentistry/adult-orthodontics/what-swollen-gums-with-braces-means-for-your-oral-health-1015
  2. Mayo Clinic Staff: Dental braces. Mayo Clinic, 2019.
    https://www.mayoclinic.org/tests-procedures/braces/about/pac-20384607
  3. Reviewed by Michael Friedman, DDS: Your guide to dental care products. WebMD Medical Reference, 2019.
    https://www.webmd.com/oral-health/guide/dental-health-dental-care-products
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